4-Year Surgerversary

Mar 19, 2012

March 19, 2012 is my 4-year surgerversary! In that time, my life has changed completely. I've lost well over 100 lbs & I’m about half the size I was at my heaviest. Although it's a daily struggle to make good food choices & control my snacking, I've become so much healthier and happier since my surgery. I am thrilled with my weight-loss and the additional health benefits I’ve been given. Quite frankly, I would have been happy leaving it at that, but I am even more thrilled with the results since my OHIP-covered breast reduction & self-paid tummy tuck about 2 years ago.

I’ve also been happy with the many lessons I’ve learned throughout this journey, including my lifestyle changes and the lifelong friendships I've made. Sure, some friends (old & new) disappointed me, but I really learned how to weed out the true-blue friends from the others. The support and friendship I was fortunate enough to forge through this journey have been invaluable to me. I thank you, friends. You know who you are. I couldn’t have done it without you.

Part 1 – The Good

Weight Loss:
·         Starting weight = 240.6 lbs. 
·         Goal weight = 130.6 lbs. 
·         Lowest weight = 118.6 lbs.
·         Total = 122 lbs or 12 lbs below goal.

The Numbers: 
     03/03/08-03/18/08 -16.0 lbs on Optifast  224.0 lbs
     03/19/08-04/18/08 -16.6 lbs in Month 1   207.4 lbs
     04/19/08-05/18/08 -10.8 lbs in Month 2   196.6 lbs (Onderland!)  
     05/19/08-06/18/08   -9.0 lbs in Month 3   187.6 lbs (Obese!)
     06/19/08-07/18/08   -9.2 lbs in Month 4   178.4 lbs
     07/19/08-08/18/08 -10.0 lbs in Month 5   168.4 lbs
     08/19/08-09/18/08   -8.4 lbs in Month 6   160.0 lbs (Overweight!)
     09/19/08-10/18/08   -7.6 lbs in Month 7   152.4 lbs
     10/19/08-11/18/08   -5.4 lbs in Month 8   147.0 lbs
     11/19/08-12/18/08   -7.8 lbs in Month 9   139.2 lbs (Century Club!)
     12/19/08-01/18/09   -0.8 lbs in Month 10  138.2 lbs 
     01/19/09-02/18/09   -1.2 lbs in Month 11  137.2 lbs
     02/19/09-03/18/09   -2.4 lbs in Month 12  134.8 lbs
     03/19/09-04/18/09   -2.2 lbs in Month 13  132.6 lbs (Normal!)
     04/19/09-05/18/09   -3.2 lbs in Month 14  129.4 lbs (Goal!)
     05/19/09-06/18/09  +2.0 lbs in Month 15  131.4 lbs
     06/19/09-07/18/09   -2.2 lbs in Month 16  129.2 lbs
     07/19/09-08/18/09   -0.2 lbs in Month 17  127.2 lbs
     08/19/09-09/18/09  +0.6 lbs in Month 18  127.8 lbs
     09/19/09-10/18/09  +0.8 lbs in Month 19  128.6 lbs
     10/19/09-11/18/09  +1.4 lbs in Month 20  130.0 lbs
     11/19/09-12/18/09   -5.0 lbs in Month 21  125.0 lbs (Thanks to Plastics!)
     12/19/09-01/18/10  +1.6 lbs in Month 22  126.6 lbs
     01/19/10-02/18/10   -1.6 lbs in Month 23  125.0 lbs
     02/19/10-03/18/10   -1.0 lbs in Month 24  124.0 lbs     
     03-19/10-03/19/11   -5.4 lbs in Year 3       118.6 lbs

Inches Lost:
     17.5 inches from my waist 
     14.5 inches from my bust 
     10 inches from my chest 
     17 inches from my hips
     5 inches from my upper arm 
     1.5 inches from my elbow
     6.5 inches from my thigh
     4 inches from my calf
     4 inches from my knee
     4.5 inches from my neck 
     1.5 inches from my ankle
     Total lost = 86 inches

Clothing Sizes:
·         At my lowest, I wore size 2/4 pants from size 24. (I even got into size zero Tommy jeans!)
·         I could also wear size XS/S tops, sweaters & coats. 
·         My shoe size has decreased from a 7 to a 5.5 or a 6.  

Health:
·         I rarely feel the pain in my knees due to arthritis.
·         My hypertension is non-existent. In fact, my blood pressure is on the low end of normal.
·         My sleep apnea has been officially ruled gone!
·         I happily cross my legs, tuck in my shirt & wear high heeled shoes - all things I could not do before surgery.
·         My transfer addictions? Shopping, shoes & Tim Horton’s coffee. 

Me: Before WLS & at my lowest in 02/10:

 

Part 2: The Bad  

Gallbladder/Hernia:
One in four WLS patients who go into surgery with their gallbladders intact  will have to have it removed afterwards. I fell into this category. I had one full-blown attack just 2 months after surgery – which was miserable – and then had it scheduled for removal. I then had what I thought was another gallbladder attack just before surgery. It turned out to be an intermittent bowel obstruction caused by a small intestinal hernia. So, the gallbladder surgery was moved up & I got both issues fixed at the same time. This surgery was a breeze compared to WLS & plastics. Now all is good.  

Anemia:
At about 3 years out, I became anemic. Once iron levels get low it’s really hard to get them back up. My ferritin levels (iron stores) are low too. This makes me tired & it becomes very hard to concentrate. It sucks. But, I’m working with a knowledgeable blood resource (Leona from OH at Humber River) and I’m going to get those levels back up. Dammit! In fact, I had an iron infusion just a few days ago & I’m hopeful I’m on my way to getting this under control. (Note: if you have low iron, don’t take iron sulphates, take heme iron. Google it. Don’t waste your time or money on the other stuff.)  

Hypoglycemia:
I get low sugar episodes if I forget to eat, or after eating too many carbs at once. An “episode” may result in some or all of the following: racing heart, sweating, shaking, weakness, dizziness, tearfulness, confusion, temporary blindness & fainting. It’s really awful. I now eat small, healthy snacks throughout the day. I also keep glucose tablets at home, at work, in my purse, in the car etc. My friends & family now know the signs of an oncoming episode & help me. This can be controlled & I haven’t had an episode in months.

Emotional Impact:
Something that has taken me by surprise is the emotional impact of this journey. Like many people who struggle with obesity, I carried with me some baggage from my childhood & teenage years. Denial & suppression were tools that worked well for me, as long as I was able to eat my way out of my emotions. With the removal of eating as a coping tool, I found myself struggling emotionally. I was unable to pull myself out of a blue period in November, 2010. Fortunately, I was not too proud to get help. I went to my family doctor & with the help of meds & therapy, I’m happy to report that I’m working through some issues that, quite frankly, were long past their due dates. I’m feeling much better and good things are happening in my personal life. So, it’s all good and I’m happier than I’ve been in a long time. After 16 months I’m now completely weaned off my meds & feel like a new, happy person. 

Part 3: The Reality: 

Regain is Easy!
I am so glad that I lost beyond my goal because let me tell you, those old, bad habits & cravings sure came back with a vengeance! It happened slowly at first & I have to admit that I tested the waters. After 2-3 years, I “tried” forbidden food & found that I could eat it, and at first, it didn’t seem to have an impact on my weight. I may have even been a bit smug about it! But, my lower intestine fooled me & learned to absorb calories very efficiently, thank you. Now, those little snacks have a tendency to pack onto my butt & stay there! Over the summer & fall & holidays of 2011, I gained around 20 lbs from my lowest weight. This put me about 10 lbs above my “goal” weight of 130 lbs. I started to buy larger pants & sensible shoes! I had to give my head a shake! I then put a plan together to get back on track. So far, I’ve worked my way back to my goal weight & hope to maintain this weight or lose a bit more.  

The Plan to getting back on track:
1) Follow the Basic Post WLS Rules:
·         Use dietary recommendations from Dietician as a guideline
·         Control portions – listen to my pouch as my restriction is still there.
o    Avoid “eat-everything-on-my-plate” syndrome at restaurants by putting ½ of the food in a take home container at the beginning of the meal.
o    Pour salt over what is beyond a reasonable portion
o    Share a single entrée with someone.
·         Eat 3 meals & 2 snacks per day
o    Make sure I eat a healthy breakfast
·         Minimize simple carbs (anything white) & maximize complex carbs (fruit, veggies & whole grains) o    Balance complex carbs with protein
·         Eat protein first o    Ideal protein intake = weight in lbs / 2 = protein grams / day (never exceeding 120 grams /day) 
·         Re-commit to a healthy lifestyle
2) Track, Track, Track:
·         Tracking via a daily food diary makes me accountable for everything I put in my mouth.
·         Goal = 40% of calories from protein, 30% from carbs & 30% from fat
·         I tracked EVERYTHING for the first 18 months & will track occasionally as I need to
3) Exercise:
·         3,500 calories = 1 lbs/0.5 kilos of fat
·         Cutting 500 calories each day either by diet or exercising will result in 1 lb lost/week
4) Drink Water:
·         Drink at least 64 oz/2 litres of clear, uncarbonated liquid per day
·         Don’t drink & eat at the same time to maximize satiation
·         Avoid pop & caffeine
·         Don’t drink alcohol while you’re losing weight to be kind to your liver (who’s already overworked processing the fat you’re losing)
5) Take Vitamins:
·         Injected is best. Liquid, chewable & dissolvable strips are good. Capsules are OK. Pills are just OK.
·         I will take (this will vary from person to person):
o    B-12 injection from family doctor every other month
o    2 chewable ADULT Centrum Select multi-vitamins twice per day
o    3 Chewable Bariatric Advantage Calcium Citrate tablets over the course of the day
o    2 chewable Jamieson C & D cherry flavoured tablets
o    1 TwinLab Allergy D Dry Vitamin D capsules
o    3 FeraMAX Heme Iron capsules per day (open contents in food) over the course of the day
6) Get Restful Sleep:
·         Try to get 7-8 hours of uninterrupted sleep per night.
·         Nap if I have to.
·         Go to bed at the same time every night
·         Limit caffeine after 2:00 pm.
7) Track Weight:
·         Weigh myself daily – at the same time of the day – to avoid weight creep
·         Allow realistic weight fluctuations of 5-8 lbs.
8) Control Unhealthy Snacking:
·         Don’t bring crap in the house.
·         Cut out late night snacking & stop eating at 8:00 pm.
·         Plan my snacks
·         Avoid justifications/rationalizations:
o    It’s my birthday! It’s your birthday! It’s Thanksgiving/Christmas/Easter/Hallowe’en/Pollywog Day! It’s free muffin day! It’s the week-end! I’m on vacation! I’ve been good & I deserve it! Three bags of chips for $1.00! I HAVE to support the Girl Guides! Yada, yada, yada.
·         Avoid Simple Carbs
o    Simple carbs drive carb cravings. Period. Stop it!
o    5-day pouch test is a good tool to purge simple carbs & cravings from system.
9) Maintain Support:
·         I will lean on my family & friends & thank those who kindly tell me I need to get back on the wagon. Thanks Patty.
·         I will continue go to WLS Coffee Groups & Support Groups.
10) Be Resilient:
·         I will remember that I am a good person who deserves to be healthy.
·         I will not let a setback paralyze me. My next snack, meal or morning represents a fresh start. ·         I will remember that lifestyle change is a marathon, not a sprint.
·         I will remember that I am not perfect, nor do I need to BE perfect.
·         I will establish realistic goals & milestones!

Me today:



In My Humble Opinion:

Surgery Process:
Four years ago, when I was applying for surgery, I’d heard there was a five-year waiting list! Shocking! To date, I have never heard of anyone who had to wait that long. It’s a myth. Four years ago, it took me one month to get my referral from my family doctor to an appointment with a surgeon. From there, I diligently did all my follow up appointments & got my surgery within six months. Now, at the time, many surgeries were being referred to the US, which was helping with the overflow. Then things changed. First, the Ontario government decided to invest in WLS. To manage funds, they pulled US surgeries before the medical infrastructure in Ontario was ready. This did increase wait times to up to 2 years & put a new application process in place. Fortunately, since then, more doctors have been trained to perform the surgeries & more hospitals are open to do it. Slowly things are improving. I’m hopeful improvements will continue.  

I’m Happy:
·         The Ontario Government is investing in WLS.
·         More surgeons are trained to perform the surgeries & as time goes on, they’ll have more experience.
·         More hospitals are open to perform the surgeries.
·         Everybody will get the after care they need.
·         The process is improving.  

I’m not happy:
·         WLS patients are mostly limited to RNY surgery. VSG & DS should be options under more circumstances.
·         With the lack of bariatric knowledge many family doctors have.
·         With the lack of bariatric training Dieticians and Nurses in bariatric clinics & on bariatric surgery floors have.
·         With the inconsistency between hospitals on the process and in the post-surgery information shared.
·         That high risk people, or those with very high BMI’s, are regularly being denied surgery.
·         With the level of plastics coverage for post WLS patients.  

Summary:
So, with 4 years of experience under my belt, and, having seen the good, the bad & the reality of this WLS amusement park ride, would I do it again? Absolutely! WLS continues to be an excellent option for people who are committed to getting healthier and making lifestyle changes. My only regret is not doing it sooner!

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